Active NPI
Daniel Joseph Piccillo, D.C.
- Chiropractor
- Philadelphia, PA
National Provider Identifier
1164794889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC010552
- Practice address
- 2401 E Tioga St
Philadelphia, PA 19134-4625 - Phone
- (267) 519-9547
- Fax
- (267) 519-9567
- NPI assigned
- Jan 27, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC010552 | PA | Primary |
Addresses
Primary practice location
2401 E Tioga St
Philadelphia, PA 19134-4625
Mailing address
901 N Penn St
F904
Philadelphia, PA 19123-3132
Phone (570) 417-1509
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120215000024 | PA | Practitioner - Chiropractic | 4880655430 | Practice locations: Philadelphia, PA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutche Chiropractic, Inc | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Philadelphia, PA
- NPI 1568613883
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442016000000",
"number": "1164794889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 N PENN ST",
"address_2": "F904",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191233132",
"telephone_number": "570-417-1509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 E TIOGA ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191344625",
"telephone_number": "267-519-9547",
"fax_number": "267-519-9567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICCILLO",
"first_name": "DANIEL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-27",
"last_updated": "2015-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC010552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.